Effects of Ketoacidosis and Puberty on Basal and TRH-Stimulated Thyroid Hormones and TSH in Children with Diabetes Mellitus

Abstract

Basal and TRH-stimulated thyroid hormones and TSH were evaluated in two groups of prepubertal and pubertal diabetics: group B - 45 children without ketoacidosis; group C - 16 children with ketoacidosis. The diabetic patients showed no signs of diabetic microangiopathy. Fifty-three healthy subjects served as controls (group A). T4, T3, FT4 and FT3 serum levels were reduced in diabetics, particularly in ketotic ones; T4 and T3 values were lower in pubertal than in prepubertal non-ketotic diabetics and in pubertal than in prepubertal controls, while no significant difference was observed between pubertal and prepubertal ketotic patients. Moreover, no difference in rT3 serum concentrations was found between group A, B and C, but non-ketotic and ketotic pubertals showed a significant rT3 reduction if compared with non-ketotic and ketotic prepubertals and with healthy pubertals. TBG was lower in group B and group C diabetics than in controls. After TRH stimulus, T3 levels showed a significant increase both in controls and in non-ketotic diabetics, while no variation was observed in ketotic children; furthermore, at 120 minutes T3 values were lower in diabetic than in healthy children, particularly in ketotic ones. Basal TSH serum concentrations were reduced in ketotic diabetics, while no difference was found between nonketotic and control subjects. After TRH stimulus, TSH peak was higher in pubertal non-ketotic diabetics than in pubertal controls, while no difference was found between prepubertal and pubertal diabetics, both in non-ketotic and in ketotic status.(ABSTRACT TRUNCATED AT 250 WORDS)

Leptin levels in non-obese and obese children and young adults with type 1 diabetes mellitus

“…This could explain the lack of difference between diabetics and control subjects. In accordance with this hypothesis, it is well known that, in diabetic patients with poor metabolic control, abnormalities of thyroid hormones, growth hormone, sex steroids, growth hormone-binding proteins and other parameters are frequently detected (25)(26)(27)(28)(29); in contrast, in diabetic patients with improved metabolic control, normalization of the above abnormalities is generally obtained (30)(31)(32)(33). It is possible that in diabetic children (obese and non-obese) with poor metabolic control significant differences in leptin concentrations could have been found.…”